In the office of Dr. Randy Wexler, flu vaccinations are usually a simple routine -- the patient arrives, gets the shot, and leaves shortly thereafter.
But Wexler, an assistant professor at Ohio State University, says that recently, what a normally simple matter has become a big headache, as frustrated patients line up for a shot that is currently in short supply.
"We are getting killed here," he said. "We get calls daily to be put on the H1N1 'list,' though… people who are not on the high-risk list get upset when told that [there is no list]."
With more than twice the number of phone calls per day, and a growing number of flu patients, he said, "this is just the beginning… [it's] going to be a long winter."
Wexler is not alone. At a time when federal health officials and state health departments are reassuring the public that there will be enough doses of the new vaccine to go around, a slow and sporadic supply has caused trouble for doctors on the ground who must address their patients' demands for the vaccine.
Judging from what health officials have to say, it may be a while yet before the supply problems are ironed out.
At a Friday briefing, Dr. Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases, said that while the CDC had predicted there would be around 40 million doses available for use by end of the month, the new estimates have been slashed to 30 million or less – making it much more challenging for states to vaccinate their populations for several weeks to come.
The CDC affirms that eventually there will be enough H1N1 vaccine for all, and most of the state and county health departments contacted by the ABC News Medical Unit did not seem as distressed about supply.
"It's not a shortage," said Amy Caruso, the public information officer for the state of North Carolina. "More is on its way; they're going to keep producing."
H1N1 Vaccine 'On Its Way' -- But Quickly Enough?
Elizabeth Turnipseed, disease control director for the Jefferson County Department of Health in Birmingham, Ala., said, "one of the challenges is the rolling release of vaccine in fairly modest quantities, [but we have] no major problems at this point."
But for physicians, obstetricians, and pediatricians who treat high-risk patients, waiting for more "on its way" is easier said than done.
"[Doctors] don't know what to tell… patients," said Dr. Marjorie Bowman, a professor of Family Practice and Community Medicine at the University of Pennsylvania. She said the shortage of vaccine doses "creates mucho extra work for the doctors and doctors' offices, which in turn, costs us money which we cannot recoup from whatever amount we will get from final vaccinations we get to do."
Dr. Brenna Anderson, the director of Reproductive Infectious Diseases Consultation at the Warren Alpert Medical School, treats high-risk pregnant women: "I think that many pregnant patients are beginning to get anxious for the vaccine…[we] have been receiving a lot of questions about when the vaccine will be available."
The same appears to be true for many pediatricians' offices. Dr. Tanya Remer Altmann, a pediatrician in southern California, said, "Phones are ringing off the hook with parents asking if we have the vaccine… That, combined with the phone call from moms whose children have 103-degree fevers, is overwhelming for our doctors and staff."
But not all doctors are overwhelmed. Dr. Joe Breault, chair of the Ochsner Health System Institutional Review Board in Louisiana, says his patients have been a bit more patient: "Many people ask about [the vaccine] and would like to get it earlier, [but] we explain it all comes through the [federal government and] then the state government [before the] clinics, and they seem to understand it just takes time to get it, and people seem understanding."